Experiences of health professionals in early parenthood

The main health professionals parents accessed in early parenthood were maternal child health nurses, though a few parents also mentioned GPs, paediatricians, lactation consultants (private and at breastfeeding clinics), and nurses at 'sleep school' (early parenting centres). See also Experiences with health professionals for antenatal and postnatal depression.

Parents had mixed experiences of the health professionals they encountered. Health professionals who were perceived as flexible, sensitive, interested, caring, knowledgeable or accessible were appreciated and helped parents feel 'supported' and 'understood'. In contrast, parents were critical of health professionals who they felt were 'set in their ways', offered 'blanket advice', lacked knowledge, were hard to access, or seemed focused on the baby rather than both baby and mother. Parents described feeling 'undermined' or 'judged' by these kinds of health professionals, or said they became reluctant to disclose to them how they were feeling.

Breastfeeding and settling were key topics that new parents sought guidance on (see also Caring for a baby - feeding and settling). They were grateful when health professionals showed flexibility in providing advice rather than advocating 'one-size-fits-all' or 'dogmatic' approaches. Nellie, a mother of two, described her frustrations with getting help with breastfeeding: 'They all said, "What's the problem with formula?" And for me, one really important thing is that idea around maternal self-efficacy. What factors are important to you in your role or identity as mother? What things are integral to that identity? And they don't take that into account. They give blanket advice'.

Michelle described her son's paediatrician as the 'voice of reason' on the subject of breast versus bottle feeding, in contrast to the 'pressure' to breastfeed she experienced from the midwives and nurses during her postnatal hospital stay.

Joanne felt the maternal child health nurse centre she went to 'wasn't very good'. She found the nurses inflexible, unresponsive and not very 'caring'.

Some mothers appreciated having a more personalised and/or long-term relationship with the health professionals they saw. For a few women this was with their maternal child health nurse, including Tina, a migrant mother from Iran: 'Oh, they were lovely. They helped me a lot I can say, maybe sometime even more than the GP. There was a Maternal Child Health Centre close to my place and I used to go there for regular visits for my child. They were very supportive, provided valuable care and information to me and my little daughter'.

Other women appreciated their relationship with their GP for same reason, including Kate whose GP had known her for a long time and was able to reassure her that her distress in early parenthood was not postnatal depression: 'He was very sweet and let me talk and cry but said, "It's perfectly normal. You need to get some rest and make some time for you, but what you're feeling is perfectly normal," and I think that was really good'.

After finding the maternal child health nurse 'judgemental' during the initial home visit, Kirsty resumed seeing the same GP who she had seen during pregnancy. She felt he cared for her baby and she was able to talk to him.

Parents valued health professionals who showed an 'interested' or 'sensitive' attitude. In contrast, some parents described being given advice or asked questions they felt were irrelevant to their situation. This made building 'rapport' difficult. As Elly, a mother of one, explained: 'I remember numerous times being asked about my husband and if he's being violent at home and I respect that this is obviously an issue that does occur for women who are vulnerable but for me - it just wasn't on my radar'.

Tolai appreciated her maternal child health nurse's knowledge of her children and felt comfortable asking the nurse questions about both her children and her own wellbeing.

Sarah M said the focus on family violence at her maternal child health centre meant someone experiencing 'emotional issues' probably 'slipped through the cracks'.

Others described being frustrated by what they saw as maternal child health nurses' exclusive focus on the baby and limited interest in the mother, particularly in relation to her emotional wellbeing. A couple of mothers echoed Elizabeth's comment: 'Maternal and child health nurses I think would be better called child health nurses. I don't think there was very much time at all [during appointments] focused on, "How are you feeling, how are you coping? Talk to me about what's going on". The baby was very healthy and that was the endgame'.

Louise welcomed greater awareness of new parents' emotional needs and postnatal depression, but questioned whether health professionals were 'trained' to provide adequate support.

A few women who had more than one child or were expecting their second discussed differences between the maternal child health nurses they had seen for each child. Elly who described 'lying' to her maternal child health nurse about bottle feeding her first child as was ashamed she was unable to breastfeed felt more comfortable with the nurse she was seeing for her second baby. She said: 'You need to find someone that you can really talk to and trust. I've had girls at mothers group who have changed their maternal child health nurse because they didn't like the one that they had - if you don't like them, you don't have to stay with them'.

Georgia felt she was able to be more open about her emotional distress with the maternal child health nurse she saw for her second child as they had 'great rapport'.

Health professionals seen as lacking appropriate knowledge with which to support new mothers were encountered by a few women. Nellie, a mother of two children, experienced mastitis and an abscess on her breast with her first child and it took her a long time to find appropriate help. She said: 'I think number one, doctors are hopeless at dealing with anything. GPs, unless they specialise in breastfeeding stuff or motherhood stuff - even female doctors aren't that good. I saw about five of them and until I saw [doctor's name] no-one gave me good advice'.

Jane described how sleep school staff and maternal child health nurses were not well equipped to deal with twins.

Accessibility and affordability of specialised help, particularly for feeding problems, was raised by some mothers. A couple of women felt lactation consultants were expensive, or described long waiting periods before getting an appointment. For others who gave birth at hospitals with satellite breastfeeding clinics, getting help for feeding was easier. As Rumer said: 'The breastfeeding clinic was fantastic. They were lactation consultants and they knew what they were talking about rather than the midwives in the hospital who were a bit inconsistent'.

Deb lived in a regional area and found it very difficult to access help for breastfeeding.